Provider Demographics
NPI:1326129891
Name:JOSLYN, ELAINE WELSH (DO)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:WELSH
Last Name:JOSLYN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4601 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64124-2927
Mailing Address - Country:US
Mailing Address - Phone:816-241-6334
Mailing Address - Fax:816-241-5830
Practice Address - Street 1:4601 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64124-2927
Practice Address - Country:US
Practice Address - Phone:816-241-6334
Practice Address - Fax:816-241-5830
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2F46207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO11785054OtherBCBS OF KC
MO000015568OtherPTAN
MO242184612Medicaid
MOE22817Medicare UPIN
MO242184612Medicaid